Apply for Membership with the Kelly Lake Métis Settlement Society

The information collected in this application is for the purpose of determining Apetokosan Nation Membership. If you have questions please contact us.

Please fill out the online form below or download the application and submit it here or mail to:

Kelly Lake Metis Settlement Society
Box 54, Tomslake, B.C. V0C 2L0

Download Membership Application

Member Information

Questionnaire

Dependant

Parents / Legal Guardian

Member Information

Legal First Name*

Legal Last Name*

Legal Middle Name*

Home Address*

City*

Province/State*

Postal Code / Zip Code*

Country*

Date of Birth*

Gender*

Place of Birth*

Primary Phone*

Secondary Phone*

Email*

Preferred Method of Contact*

Phone

Text

Is Your Mailing Address Different From Your Home Address*

Mailing Address

Mailing Address City

Province / State

Postal / Zip Code

Country

Do you identify as Metis?*

Are you registered under Bill C-31?*

Have any of your parents gained Indian status through Bill C-31 (1985)?*

Are you a member of any other aboriginal or indigenous group, community or organization?*

If yes, please explain:*

Children/Dependants

Legal Name

Gender

Date of Birth

Birthplace

Legal Name

Gender

Date of Birth

Birthplace

Legal Name

Gender

Date of Birth

Birthplace

Legal Name

Gender

Date of Birth

Birthplace

Legal Name

Gender

Date of Birth

Birthplace

Legal Name

Gender

Date of Birth

Birthplace

Parents & Legal Guardians

Legal Name

Gender

Date of Birth

Birthplace

Do they identify as Metis?

Parent Legal Name 2

Gender

Date of Birth

Birthplace

Do they identify as Metis?

HP Name